Jogo Sério para reabilitação do equilíbrio de hemiparéticos por acidente vascular cerebral
DOI:
https://doi.org/10.34024/rnc.2021.v29.11333Palavras-chave:
Jogos de Vídeo, Reabilitação, Equilíbrio Postural, Acidente vascular encefálico; Marcha; Cognição; Hemiparesia., Acidente Vascular CerebralResumo
Introdução. Pacientes hemiparéticos por acidente vascular cerebral (AVC) possuem déficits funcionais residuais, incluindo alterações do equilíbrio, o que impacta na qualidade de vida. O uso de tecnologias inovadoras tem aumentado na reabilitação, entre estes recursos estão os Jogos Sérios (JS). Objetivo. Verificar os efeitos terapêuticos de um programa de exercícios utilizando um JS desenvolvido para avaliação e reabilitação do equilíbrio de pacientes hemiparéticos por AVC. Método. Trata-se de um estudo quase-experimental do tipo séries de tempo, envolvendo 12 pacientes com hemiparesia pós-AVC. A intervenção durou 10 semanas, com as sessões realizadas duas vezes por semana. Foram avaliados: força muscular de quadríceps femoral (dinamometria), equilíbrio (estabilometria dinâmica e Escala de Equilíbrio de Berg), mobilidade funcional (Timed Up and Go Test) e percepção da qualidade de vida (Perfil de Saúde de Nottingham). Resultados. Melhoras significativas e com grande tamanho de efeito (TDE) foram observadas em todas as variáveis, com exceção da força muscular no membro não parético, que apresentou TDE moderado. Destacam-se os incrementos em todos os testes de equilíbrio (p<0,001; TDE: 0,9). Conclusões. Um programa de exercícios com JS parece ser uma boa opção de tratamento para pacientes hemiparéticos após AVC, especialmente para a melhora do equilíbrio. Este recurso pode contribuir no processo de reabilitação destes pacientes.
Downloads
Métricas
Referências
Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, et al. Heart disease and stroke statistics-2017 Update: a report from the American Heart Association. Circulation 2017;135:146-603. http://dx.doi.org/10.1161/CIR.0000000000000485
Najafi Z, Rezaeitalab F, Yaghubi M, Manzari ZS. The effect of biofeedback on the motor - muscular situation in rehabilitation of stroke patients: a randomized controlled trial. Int J Caring Sci 2018;7:89-93. http://dx.doi.org/10.15171/jcs.2018.014
Caires TA, Silva GV, Castro SS, Souza LAPS. Trunk control and its relation with clinical condition, central anatomic area and post-cerebrovascular accident phase. Fisioter Pesq 2018;25:224-8.
http://dx.doi.org/10.1590/1809-2950/17025025022018
Annethattil A, Paul J, Kumar P, Krishnamurthy R, Kumar A. The effectiveness of balance training without visual feedback in stroke subjects. IJMAES 2018;4:448-52.
http://dx.doi.org/10.36678/ijmaes.2018.v04i01.002
Van Duijnhoven HJ, Heeren A, Peters MA, Veerbeek JM, Kwakkel G, Geurts AC, et al. Effects of exercise therapy on balance capacity in chronic stroke: systematic review and meta-analysis. Stroke 2016;47:2603-10. http://dx.doi.org/10.1161/STROKEAHA.116.013839
Song M, Lee J, Shin W. Minimal clinicaly important difference of berg balance scale scores in people with acute stroke. Phys Ther Rehabil Sci 2018;7:102-8. http://dx.doi.org/10.14474/ptrs.2018.7.3.102
Yatar GI, Yildiri, SA. Wii fit balance training or progressive balance training in patients with chronic stroke: a randomized controlled trial. J Phys Ther Sci 2015;27:1145-51.
http://dx.doi.org/10.1589/jpts.27.1145
Noveletto F, Soares AV, Mello BA, Savegnani CN, Eichinger FLF, Hounsell MS, et al. Biomedical serious game system for balance rehabilitation of hemiparetic stroke pacients. IEEE Trans Neural Syst Rehab Eng 2018;26:2179-88.
http://dx.doi.org/10.1109/TNSRE.2018.2876670
Noveletto F, Soares AV, Eichinger FLF, Domenech SC, Hounsell MS, Bertemes Filho P. Biomedical serious game system for lower limb motor rehabilitation of hemiparetic stroke patients. IEEE Trans Neural Syst Rehab Eng 2020;28:1481-7.
http://dx.doi.org/10.1109/TNSRE.2020.2988362
Juras G, Brachman A, Michalska J, Kamieniarz A, Pawlowski M, Hadamus A, et al. Standards of virtual reality application in balance training programs in clinical practice: a systematic review. Games Health J 2019;8:101-11. http://dx.doi.org/10.1089/g4h.2018.0034
Who - World Health Organization. Classificação internacional de funcionalidade, incapacidade e saúde – CIF. 2004;238p. https://catalogo.inr.pt/documents/11257/0/CIF+2004
Cooper A, Alghamdi GA, Alghamdi MA, Altowaijri A, Richardson R. The relationship of lower limb muscle strength and knee joint hyperextension during the stance phase of gait in hemiparetic stroke patients. Physiother Res Int 2011;17:150-6.
http://dx.doi.org/10.1002/pri.528
Bertolucci PHF, Brucki SMD, Campacci SR, Juliano YO. Mini-exame do estado mental em uma população geral: impacto da escolaridade. Arq Neuropsiquiatr 1994;52:1-7. http://dx.doi.org/10.1590/S0004-282X1994000100001
Cohen J. Statistical power analysis for the behavioral sciences. 2nd edition. New Jersey: Lawrence Erlbaum Associates (Pub); 1988. http://www.utstat.toronto.edu/~brunner/oldclass/378f16/readings/CohenPower.pdf
Winstein CJ, Stein J, Arena R, Bates B, Cherney LR, Cramer SC, et al. Guidelines for adult stroke rehabilitation and recovery. Stroke 2016;47:98-169. http://dx.doi.org/10.1161/STR.0000000000000098
Dias P, Silva R, Amorim P, Lains J, Roque E, Pereira ISF, et al. Using virtual reality to increase motivation in poststroke rehabilitation. IEEE Comput Graph Appl 2019;39:64-70.
http://dx.doi.org/10.1109/MCG.2018.2875630
Dorsch S, Ada L, Canning CG. Lower limb strength is significantly impaired in all muscle groups in ambulatory people with chronic stroke: a cross-sectional study. Arch Phys Med Rehabil 2016;97:522-7. http://dx.doi.org/10.1016/j.apmr.2015.10.106
Franciulli PM, Magaldi CM, Bigongiari A, Barbanera M. Efeito do treinamento resistido em hemiparéticos crônicos no equilíbrio e torque isocinético do joelho. Rev Bras Cienc Saúde 2018;22:125-30. http://dx.doi.org/10.22478/ufpb.2317-6032.2018v22n2.32752
Miranda CS, Oliveira TP, Gouvêa JXM, Perez DB, Marques AP, Piemonte MP. Balance training in virtual reality promotes performance improvement but not transfer to postural control in people with chronic stroke. Games Health J 2019;8:294-300.
http://dx.doi.org/10.1089/g4h.2018.0075
Park J, Chung Y. the effects of robot-assisted gait training using virtual reality and auditory stimulation on balance and gait abilities in persons with stroke. NeuroRehab 2018;43:227-35. http://dx.doi.org/10.3233/NRE-172415
Lopes PC, Carvalho JDP, Neto HBDS, Souza KCLD, Taddeo PDS, Praça LR, et al. Realidade virtual em uma estratégia de reabilitação neurofuncional: revisão sistemática. Varia Sci Cienc Saúde 2017;3:1-13. https://dx.doi.org/10.48075/vscs.v3i1.16813
Kannan L, Vora J, Bhatt T, Hughes S. Cognitive-motor exergaming for reducing fall risk in people with chronic stroke: a randomized controlled trial. NeuroRehab 2019;44:493-510.
http://dx.doi.org/10.3233/NRE-182683
Chan PPK, Si Tou JIF, Tse MMY, Ng SSM. The reliability and validity of the timed up and go (motor) test for people with chronic stroke. Arch Phys Med Rehabil 2017;98:2213-20.
http://dx.doi.org/10.1016/j.apmr.2017.03.008
De Rooij IJM, Van De Port IGL, Meijer JWG. Effect of virtual reality training on balance and gait ability in patients with stroke: systematic review and meta-analysis. Phys Ther 2016;96:1905-18.
http://dx.doi.org/10.2522/ptj.20160054
Lee HS, Park YJ, Park SW. The effects of virtual reality training on function in chronic stroke patients: a systematic review and meta-analysis. BioMed Res Int 2019;8:1-12.
http://dx.doi.org/10.1155/2019/7595639
Lapadatu I, Morris R. The relationship between stroke survivors’ perceived identity and mood, self-esteem and quality of life. Neuropsychol Rehabil 2019;29:199-213.
http://dx.doi.org/10.1080/09602011.2016.1272468
Aramaki AL, Sampaio RF, Reis ACS, Cavalcanti A, Dutra FCS. Virtual Reality In the rehabilitation of patients with stroke: an integrative review. Arq Neuropsiquiatr 2019;77:268-78.
http://dx.doi.org/10.1590/0004-282X20190025
Tastekin N. Rehabilitation and quality of life in stroke patients. Turk J Phys Med Rehabil 2015;61:1-8.
http://dx.doi.org/10.5152/tftrd.2015.001
Mcgrane N, Galvin R, Cusack T, Stokes E. Addition of motivational interventions to exercise and traditional physiotherapy: a review and meta-analysis. Physiotherapy 2015;101:1-12.
http://dx.doi.org/10.1016/j.physio.2014.04.009
Soares AV, Borges-Júnior NG, Hounsell MS, Marcelino E, Rossito GM, Sagawa-Júnior Y. A serious game developed for physical rehabilitation of frail elderly. Eur Res Telemed 2016;45-53. http://dx.doi.org/10.1016/j.eurtel.2016.05.003
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2021 Rafaela Korn, Danielle Fernandes dos Santos, Antonio Vinicius Soares, Fabrício Noveletto, Fernando Luís Fischer Eichinger
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Aceito: 2021-07-26
Publicado: 2021-09-08
Português
English
Español
